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Peds & Immunization

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olanjones's version from 2017-09-27 18:53

Developmental Milestones

Question Answer
2 monthPosterior fontanel closes, ↓tonic neck & Moro reflex, tracks with eyes
4 monththumb apposition, absent tonic neck & Moro, drooling
5 monthbirth weight doubled, takes objects presented
6 monthsteething, turn from back to stomach, distinguish & recognize strangers
7 monthsits with support, grasp toy with hand, stranger anxiety
9 monthbrings self to sitting, might say mama/dada, responds to parental anger
10 monthpulls self to standing, brings hands together
12 monthbirth weight tripled, walks (w/ help), 2 finger pincer grasp (eats w/ fingers)
15 monthwalks alone, builds 2-block tower, throws objects, names commonplace objects
18 monthanterior fontanel closes, climbs stairs, 3-block tower, thumb sucking, scribbles, time for screening for developmental delay & autism
24 monthjumping, 6-block tower, 300-words, obeys easy commands
30 monthsphincter control (toilet training), stands on 1 foot, walks tiptoe, 8-block tower
3 yearrides tricycle, walks backwards & down stairs, undresses w/out help, 900-words, learns from experience, imaginary friends
4 yearclimbs/jumps/hops, laces shoes, brushes teeth, 1500-words, throws overhead
5 yeardresses w/out help, 2100-words, tolerates ↑separation from parents, gender-specific behavior
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Stages of Play Development

Question Answer
Exploratoryholding toys – small enough to grasp/large enough for safety; 0-1 yr
Toys as adult toolsimitation ; 1-7 yr
Games & hobbiesallows for cooperative play; 8-12 yr
Solitary playalone but enjoys presence of others; infancy
Parallel playplays alongside but not with; toddlers
Associative playno group goal, often follows a leader; preschool
Cooperative playorganized, rules, leader/follower relationship established; school-age
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Intellectual Delays

Question Answer
Nursing implementationsassist parents w/ adjustment, provide sensory stimuli, encourage socially acceptable behavior, provide emotional support
Fetal alcohol syndromethin upper lip, epicanthal folds, maxillary hyperplasia, microcephaly, small for gestational age, intellectual and motor deficiencies, hearing disorders
Down syndromemarked hypotonia, short stature, epicanthal folds, low-set ears, protruding tongue, low nasal bridge, IQ range from 20-70; ↑rates of heart disease, hearing loss, respiratory infections
Other disabilitieshyperkeniesis, perceptual deficits, aggression/depression, ↓attention span – may have average-↑IQ
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Piaget & Erikson Developmental Stages

Question Answer
Piaget - birth to 2 yearsSensorimotor: learn about the world by sensory input/motor activity
Piaget - 2-7 yearsPreoperational: thinks by using words as symbols, but logic not well developed
Piaget - 7-11 yearsConcrete operational: child can reason quite well is concrete objects are used in teaching/experimentation
Piaget - 11-end of lifeFormal operational: fully mature intellectual thought is now attained
Erikson - birth to 1 yearTrust vs Mistrust: if basic needs not met, infant will eventually learn to mistrust others
Erikson - 1-3 yearsAutonomy vs Shame: children who are criticized for autonomy (or lack of control) will feel shame (or doubt their abilities)
Erikson - 3-6 yearsInitiative vs Guilt: constant criticism for initiating activities will lead to feelings of guilt and lack of purpose
Erikson - 6-12 yearsIndustry vs Inferiority: a child takes pride in accomplishments, if they cannot accomplish what is expected they will feel inferior
Erikson - 12-18 yearsIdentity vs Role Confusion: an adolescent who cannot est. meaningful definition of self will experience confusion in one or more roles in life
Erikson - 19-40 yearsIntimacy vs Isolation: success in love leads to strong relationships, failure results in loneliness and isolation
Erikson - 40-65 yearsGenerativity vs Stagnation: success results in a sense of having contributed to the world, failure results in a feeling of being unproductive and uninvolved in the world
Erikson - 65-end of lifeEgo Integrity vs Despair: success results in a general sense of satisfaction and wisdom, failure results in regrets, bitterness, despair, and a feeling that life has been wasted
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Vaccinations

Question Answer
Live attenuated vaccineWeak form of the "wild" virus/bacteria, must replicate to be effective. Immune response is similar to natural infection (usually effective in 1 dose); DO NOT give to someone w/ compromised immune system (examples: MMR, Varicella, Nasal flu vaccine)
Inactivated vaccineGenerally require 3-5 doses. Immune response mostly humoral. Antibody titer falls over time; Principle antigen may not be defined
Active immunitypermanent; individual forms their own antibodies to antigen; has disease/gets vaccination
Passive immunitytemporary; individual gets antibodies from another source; gamma globulin, breast feeding
Invalid contraindicationsMild illness, Antimicrobial tx, disease exposure/convalescence, pregnant/immunosuppressed person in household, Breastfeeding, Preterm birth, FH of adverse events, Tb skin test/Mult vaccines
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